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Effect of renin-angiotensin system inhibitors on long-term survival in patients treated with beta blockers and antiplatelet agents after acute myocardial infarction (from the MONICA/KORA Myocardial Infarction Registry).
Am J Cardiol. 2014 Aug 01; 114(3):329-35.AJ

Abstract

Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) have shown to decrease mortality and cardiovascular morbidity especially in high-risk patients after acute myocardial infarction (AMI). Aim of this study was to assess the association between ACEI or ARB treatment (ACEI/ARB) at hospital discharge and long-term survival after AMI in real-life patient care. From a German population-based AMI registry, 3,544 patients (75.4% men), aged 28 to 74 years, hospitalized with an incident AMI between 2000 and 2008, surviving at least 24 hours and treated with β blockers and antiplatelet agents at discharge were included in this study. All data were collected by standardized interviews and chart review. End point of this study was all-cause mortality at 3 follow-up periods: 1, 3, and 5 years after AMI. Mortality was assessed for all registered patients in 2010. Survival analyses and multivariable Cox regression analyses were conducted. Of the 3,544 patients, 83.7% received ACEI/ARB and 90.1% were treated with statins at hospital discharge. During a median follow-up period of 5.0 years (interquartile range 1.0 years), 9.3% patients died. In the multivariable Cox models adjusting for a number of covariates, use of ACEI/ARB showed a significantly inverse relation with 1-, 3-, and 5-year mortality (e.g., 5-year mortality: hazard ratio 0.74, 95% confidence interval 0.59 to 0.94, p = 0.015), and the hazard ratios for mortality did not differ significantly between the 3 examined follow-up periods. In conclusion, use of ACEI/ARB at hospital discharge is independently associated with long-term survival benefit in patients with incident AMI already treated with other guideline-recommended cardiovascular drugs.

Authors+Show Affiliations

MONICA/KORA Myocardial Infarction Registry, Central Hospital of Augsburg, Augsburg, Germany; Institute of Epidemiology II, German Research Center for Environmental Health (GmbH), Helmholtz Zentrum München, Neuherberg, Germany. Electronic address: ute.amann@helmholtz-muenchen.de.MONICA/KORA Myocardial Infarction Registry, Central Hospital of Augsburg, Augsburg, Germany; Institute of Epidemiology II, German Research Center for Environmental Health (GmbH), Helmholtz Zentrum München, Neuherberg, Germany.MONICA/KORA Myocardial Infarction Registry, Central Hospital of Augsburg, Augsburg, Germany; Institute of Epidemiology II, German Research Center for Environmental Health (GmbH), Helmholtz Zentrum München, Neuherberg, Germany.Institute of Epidemiology II, German Research Center for Environmental Health (GmbH), Helmholtz Zentrum München, Neuherberg, Germany.Department of Internal Medicine I-Cardiology, Central Hospital of Augsburg, Augsburg, Germany.Department of Internal Medicine I-Cardiology, Central Hospital of Augsburg, Augsburg, Germany; Department of Internal Medicine-Cardiology, Hospital of Nördlingen, Nördlingen, Germany.Institute of Epidemiology II, German Research Center for Environmental Health (GmbH), Helmholtz Zentrum München, Neuherberg, Germany.MONICA/KORA Myocardial Infarction Registry, Central Hospital of Augsburg, Augsburg, Germany; Institute of Epidemiology II, German Research Center for Environmental Health (GmbH), Helmholtz Zentrum München, Neuherberg, Germany.

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24927969

Citation

Amann, Ute, et al. "Effect of Renin-angiotensin System Inhibitors On Long-term Survival in Patients Treated With Beta Blockers and Antiplatelet Agents After Acute Myocardial Infarction (from the MONICA/KORA Myocardial Infarction Registry)." The American Journal of Cardiology, vol. 114, no. 3, 2014, pp. 329-35.
Amann U, Kirchberger I, Heier M, et al. Effect of renin-angiotensin system inhibitors on long-term survival in patients treated with beta blockers and antiplatelet agents after acute myocardial infarction (from the MONICA/KORA Myocardial Infarction Registry). Am J Cardiol. 2014;114(3):329-35.
Amann, U., Kirchberger, I., Heier, M., Zirngibl, A., von Scheidt, W., Kuch, B., Peters, A., & Meisinger, C. (2014). Effect of renin-angiotensin system inhibitors on long-term survival in patients treated with beta blockers and antiplatelet agents after acute myocardial infarction (from the MONICA/KORA Myocardial Infarction Registry). The American Journal of Cardiology, 114(3), 329-35. https://doi.org/10.1016/j.amjcard.2014.04.046
Amann U, et al. Effect of Renin-angiotensin System Inhibitors On Long-term Survival in Patients Treated With Beta Blockers and Antiplatelet Agents After Acute Myocardial Infarction (from the MONICA/KORA Myocardial Infarction Registry). Am J Cardiol. 2014 Aug 1;114(3):329-35. PubMed PMID: 24927969.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of renin-angiotensin system inhibitors on long-term survival in patients treated with beta blockers and antiplatelet agents after acute myocardial infarction (from the MONICA/KORA Myocardial Infarction Registry). AU - Amann,Ute, AU - Kirchberger,Inge, AU - Heier,Margit, AU - Zirngibl,Angelika, AU - von Scheidt,Wolfgang, AU - Kuch,Bernhard, AU - Peters,Annette, AU - Meisinger,Christa, Y1 - 2014/05/15/ PY - 2014/03/05/received PY - 2014/04/29/revised PY - 2014/04/29/accepted PY - 2014/6/15/entrez PY - 2014/6/15/pubmed PY - 2014/9/24/medline SP - 329 EP - 35 JF - The American journal of cardiology JO - Am J Cardiol VL - 114 IS - 3 N2 - Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) have shown to decrease mortality and cardiovascular morbidity especially in high-risk patients after acute myocardial infarction (AMI). Aim of this study was to assess the association between ACEI or ARB treatment (ACEI/ARB) at hospital discharge and long-term survival after AMI in real-life patient care. From a German population-based AMI registry, 3,544 patients (75.4% men), aged 28 to 74 years, hospitalized with an incident AMI between 2000 and 2008, surviving at least 24 hours and treated with β blockers and antiplatelet agents at discharge were included in this study. All data were collected by standardized interviews and chart review. End point of this study was all-cause mortality at 3 follow-up periods: 1, 3, and 5 years after AMI. Mortality was assessed for all registered patients in 2010. Survival analyses and multivariable Cox regression analyses were conducted. Of the 3,544 patients, 83.7% received ACEI/ARB and 90.1% were treated with statins at hospital discharge. During a median follow-up period of 5.0 years (interquartile range 1.0 years), 9.3% patients died. In the multivariable Cox models adjusting for a number of covariates, use of ACEI/ARB showed a significantly inverse relation with 1-, 3-, and 5-year mortality (e.g., 5-year mortality: hazard ratio 0.74, 95% confidence interval 0.59 to 0.94, p = 0.015), and the hazard ratios for mortality did not differ significantly between the 3 examined follow-up periods. In conclusion, use of ACEI/ARB at hospital discharge is independently associated with long-term survival benefit in patients with incident AMI already treated with other guideline-recommended cardiovascular drugs. SN - 1879-1913 UR - https://www.unboundmedicine.com/medline/citation/24927969/Effect_of_renin_angiotensin_system_inhibitors_on_long_term_survival_in_patients_treated_with_beta_blockers_and_antiplatelet_agents_after_acute_myocardial_infarction__from_the_MONICA/KORA_Myocardial_Infarction_Registry__ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9149(14)01111-4 DB - PRIME DP - Unbound Medicine ER -